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1 <br /> Commonwealth of Massachusetts <br /> City/Town of Mashpee <br /> Form I I - Soil Suitability Assessment for On-Site Sewage Disposal <br /> C. On-Site Review (minimum of two holes required at every proposed primary and reserved disposal area) <br /> Deep Observation Hole Number: DOH#3 4/12/11 8:30 Clouds <br /> Date Time Weather <br /> 1. Location <br /> Ground Elevation at Surface of Hole: Location(identify on plan): See Sketch <br /> 2. Land Use Woodland None 0-3 <br /> (e.g.,woodland,agricultural field,vacant lot,etc.) Surface Stones Slope(%) <br /> Pine&Oak Outwash Plain See Sketch <br /> Vegetation Landform Position on Landscape(attach sheet) <br /> 3. Distances from: Open Water Body >500 Drainage Way >500 possible Wet Area >500 <br /> feet feet feet <br /> Property Line feet 200 Drinking Water Well NA feetOther feet <br /> 4. Parent Material: Glacial Outwash Unsuitable Materials Present: ❑ Yes ® No <br /> If Yes: ❑ Disturbed Soil ❑ Fill Material ❑ Impervious Layer(s) ❑ Weathered/Fractured Rock ❑ Bedrock <br /> 5. Groundwater Observed: ❑ Yes ® No If yes: Depth Weeping from Pit Depth Standing Water in Hole <br /> Estimated Depth to High Groundwater: 50 feet <br /> elevation <br /> t5formI I[1]mashpeedoh3-rev.1/10 Form 11—Soil Suitability Assessment for On-Site Sewage Disposal •Page 2 of 2 <br />